Administração de clonidina intravenosa e sua capacidade de reduzir a pressão da artéria pulmonar em pacientes submetidos a cirurgia cardíaca

• Autor(a) principal: João, Benedito Barbosa [UNIFESP]
• Data de Publicação: 2014
• Outros Autores: Amaral, José Luiz Gomes do [UNIFESP], Bueno, Ronaldo Machado, Ferez, David [UNIFESP], Falcão, Luiz Fernando dos Reis [UNIFESP], Perez, Marcelo Vaz, Oliveira-Júnior, Itamar Souza [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1016/j.bjan.2013.03.019; http://repositorio.unifesp.br/handle/11600/8156
• topic: Clonidine; Pulmonary hypertension; Heart surgery; Clonidina; Hipertensão pulmonar; Cirurgia cardíaca

Objective:Evaluate the ability of clonidine to reduce pulmonary arterial pressure in patients with pulmonary hypertension undergoing heart surgery, either by reducing the pressure values from the direct measurement of pulmonary arterial pressure or by reducing or eliminating the need for intraoperative dobutamine and nitroprusside.Method:Randomized, double-blind, placebo-controlled, comparative study conducted in 30 patients with pulmonary arterial hypertension type 2 undergoing cardiac surgery. Mean pulmonary arterial pressure and dosage of dobutamine and sodium nitroprusside were assessed four times: before intravenous administration of clonidine (2 µg/kg) or placebo (T0), 30 min after tested treatment and before cardiopulmonary bypass (T1), immediately after CPB (T2), 10 min after protamine injection (T3).Results:There were no significant differences regarding mean pulmonary arterial pressure at any time of evaluation. There was no significant difference between groups regarding other variables, such as mean systemic arterial pressure, heart rate, total dose of dobutamine, total dose of sodium nitroprusside, and need for fentanyl.Conclusion:Data analysis from patients included in this study allows us to conclude that intra-venous clonidine (2 µg/kg) was not able to reduce the mean pulmonary arterial pressure inpatients with pulmonary hypertension in group 2 (pulmonary venous hypertension), undergoing heart surgery, or reduce or eliminate the need for intraoperative administration of dobutamineand sodium nitroprusside.